Complications with one-piece lamellar keratolimbal grafts for simultaneous limbal and corneal pathologies

Purpose. To determine the efficacy of a one-piece lamellar keratolimbal graft for the treatment of ocular surface disorders involving the limbus and cornea. Methods. A retrospective study of a case series including eight patients with either Stevens-Johnson syndrome (four patients), ocular cicatricial pemphigoid (three patients), or familial subepithelial amyloidosis of the cornea (one case) was performed with a mean follow-up period of 18 months after surgery. Results. Of the eight cases, three patients retained a corneal epithelial appearance upon their latest visit. No statistically significant difference was observed between preoperative Visual acuity (0.013) and postoperative acuity (0.082). Stromal neovascularization was observed in all cases. Seven of eight cases experienced persistent epithelial defects (PED), four of which evolved secondary infectious ulcers. Two cases required further surgical intervention to treat PED or infectious ulcers. None of the cases developed glaucoma. Conclusion. A one-piece keratolimbal graft does not seem to offer any advantage over a two-piece limbal and corneal graft in the treatment of severe ocular surface disorders involving the limbus and cornea.